Panic attacks, anxiety and tremor

My husband, age 68, was diagnosed with Parkinson’s 6 years ago and has struggled with anxiety and depression for more than 30 years, causing him to retire from teaching at 55. He has taken Amitryptiline for years and has become psychologically attached to it because he felt so bad trying to come off it when he retired and thought he should no longer need it.
Recently, he has experienced far more anxiety and was prescribed citalopram, which was a disaster because it increased his tremors and caused extreme sweating which made him panic, which turned into a vicious cycle (the GP actually called an ambulance during one attack because his heart rate was so high!!) He stopped taking the Citalopram but was very reluctant to try anything else after that frightening experience. After a really bad series of panic attacks, the GP suggested increasing the Amitryptiline as we know he can tolerate that. It’s not really working: he is still waking in the morning - and sometimes in the night - in a panic. When he has these “attacks” his heart races, he feels hot, doesn’t chew his food or swallow, dribbles constantly and can barely function. Scary to see and, no doubt, very frightening for him.
On Friday, we saw a consultant at our local hospital for the regular Parkinson’s follow up (not a Parkinson’s specialist, as there isn’t one any more! ) who is really keen for husband to reduce - or preferably stop - the Amitryptiline and take Mirtazipine aswell/instead. He gave us a prescription but husband refused to even take it to the pharmacy. He nearly had a panic attack at the mere thought of reducing the Amitryptiline back to the 50mg he was taking until 3 weeks ago (now on 75mg).
We have, at last, got a referral to a neurologist, who we shall see next month, so we will see what she says about the best antidepressants, (although I’ll bet she’ll be equally against Amitryptiline, and I dread what will happen then! )
Anyway, sorry to write at length, but I thought the background was important. My reason for posting on here is to ask if anyone has managed to successfully deal with anxiety/panic attacks and can help us because I’m at my wit’s end.
For my own sanity, I’m trying to continue to work part-time, as a TA in a primary school - mornings only - as, I love my job, need the contact with other people and don’t feel ready to retire yet (I’m 59). Most of the time, he is quite capable, physically, of looking after himself for a few hours but this anxiety is making him frightened to be on his own. We have no nearby family.
Any suggestions, support or ideas please. Thank you

Hi @JCJ, :wave:

A warm welcome to the forum, you’ve definitely come to the right place for help and support.

Firstly, I’m sorry that you and your husband have had such a tumultuous journey with Parkinson’s so far, I’m sure it couldn’t of been easy for you both. Anxiety and depression is very common among people with Parkinson’s and there is no evidence to suggest that the symptoms of anxiety in people with Parkinson’s can be treated effectively with medication, additional to your Parkinson’s drugs.

However, your husband’s GP or specialist may discuss this option if severe anxiety is affecting the quality of your day-to-day life which seems to be the case here. As well as medication, we hear from many people with Parkinson’s who find complementary therapies relaxing and we have more information on this via our website here - https://www.parkinsons.org.uk/information-and-support/anxiety. There’s also a lot of information on this page about anxiety in general which I’m sure you’ll find helpful.

Additionally, our helpline and Parkinson’s local advisers are here to answer any questions you have about anxiety. Call us on 0808 800 0303 or email us at [email protected].

I hope you find this information helpful.

Best wishes,
Reah
Forum Community Manager